Provider Demographics
NPI:1902114085
Name:BRADY, CYNTHIA AURORA
Entity Type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:AURORA
Last Name:BRADY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 BELLA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-7908
Mailing Address - Country:US
Mailing Address - Phone:760-580-0491
Mailing Address - Fax:
Practice Address - Street 1:2204 BELLA VISTA DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-7908
Practice Address - Country:US
Practice Address - Phone:760-725-0550
Practice Address - Fax:760-580-0491
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital